药品浩繁，不下千百余种，其寻常日用者，不过百十种，而百十种之中，药有真伪好恶，用有宜与不宜，皆
当明辨而详悉者也。如赤芍药、银柴胡、赤小豆、龙骨、巨胜子、半夏曲，皆伪药也。《本草崇原》俱已辨明，但
未梓行，兹且言之。
芍药花开赤、白，赤花者为赤芍，白花者为白芍，总属一种，岂有二耶？今儿科、外科，多用赤芍，谬矣。又
以白芍为酸敛之药，岂知《本经》主治邪气腹痛，除血痹，破坚积，寒热疝瘕，气味苦平。性功如是，宁酸敛
耶？试将芍药咀嚼，酸味何在？可以正其误矣。
柴胡有硬、软二种，硬者为大柴胡，软者为小柴胡。然必出于银州者为胜，故有银柴胡之名。非大小
柴胡之外，复有银柴胡也。
赤小豆，谷类也，粗而大者为赤豆，细而小者为赤小豆。今药肆中一种草子，赤黑相兼，不可煮食，岂得
谓之豆乎？
巨胜子，即胡麻也。出于胡地之大宛者为胜，故有巨胜之名。刘阮误入天台，仙家饲以胡麻饭，即巨胜子
也。今药肆中一种有壳无仁，乃狗虱也，以狗虱而充巨胜，妄立壁虱胡麻之名。今用巨胜子，不若竟用大脂麻
矣。
龙骨，《本经》上品之药，乃上天所谪之龙，海滨深山间或有之。今一种龙骨者，乃北地深山之石垄骨，
而非上天所降之真龙。龙为阳物，能兴云布雨，故《伤寒论》中发汗名大青龙，利水名小青龙。今欲止汗，反用
龙骨，岂理也哉？《本经》言止汗者，乃以真龙之骨，研为细粉，扑其周身，塞其汗孔，即本论以温粉扑之之
义，非服食止汗之谓。
考《神农本经》止有半夏，并无半夏曲。今药肆中以明矾水煮半夏，所剩矾脚及半夏屑，大半和以麦曲，
造成药饼，为半夏曲。时人厌常新喜，方中每用，何益于病？除此之外，复有神曲，用白面百斤，青蒿、辣蓼、
苍耳自然汁，赤小豆、杏仁捣烂，拌面成饼， HT 为曲。儿医认以能治痰、止泻、消食之药，每每用之，
不知其
弊。别药煮汁各有气味，若用神曲，则药如稠粥之饮，有形之面，大能伤胃。夫婴儿有病，必忌面食，此HT 过
之面，与酱何异？况有药与草汁，并非健脾之品，用无益也。
又药之伪者，如桂枝、细辛、五味、干姜是也。仲师桂枝汤，用桂枝去皮者，止取梢尖嫩枝，内外如一，气味
辛香甜辣，桂枝皮内骨，便去之而不用。如是之枝，可多得耶？今人反用，亦必辛香甜辣，名为川桂枝方可。今
药肆中辛香甜辣之桂枝不可得，即有亦暂而不久。数十年中，余阙之不用，不得已而以官桂代之。
北细辛，其细如发，辛香触鼻。苟细不如发，辛不触鼻，便为杜衡，用之无益。
五味子，惟辽五味最佳，其黑如漆之有光，其味如醋之滴牙，上口生津。次则北五味，其色红紫，微有光，
其味亦酸，微有香气，今一种黑色如李干兼枯红之色者，用无益也。
又生姜为子姜，宣胃；干姜为母姜，温脾。脾胃有母子之分，而干姜、生姜亦有母子之分。今有金衢温台
之种姜，切片坚实黄亮，方能入药，并不是本地之生姜晒干伪充，入口最辣，止能辛散表邪，温脾用无益也。
至药之宜与不宜，先须知药性之宜否，察人之病，投之中 方宜。今世俗每用而不知宜否。今略举十数
种言之。今医发散，每用前胡，考前胡《别录》所收，陶
宏景云∶上古止有柴胡，而无前胡之名，后人用之。是宏景虽收之，而实疑之也。且前胡降痰逐风，耗散消削，
不若柴胡之芳香，清热解表之谓得也。今人不究药性，有病在太阳，而早用柴胡，有引邪入少阳之说。夫柴胡
名地勋，苗甚芳香，从未见邪入于太阳，正太阳经药也。《伤寒论》云∶无太阳证。本论云∶本太阳病不解，
转入少阳者，与小柴胡汤。谓可从少阳而外达于太阳，非少阳经之主药也。其性自下而上，从内而外，根气虚
者不可用，用之是犹揠苗助长，故本论有柴胡不中与之诫。
至于升麻，亦拔根之药。今人遇元气虚脱之证，每用升麻，欲提之使上。岂知升麻，《本经》名周麻，以
其具升转周遍之功，初病发散可用；若里虚气陷，当补益其元，助之使上，不可升提，升提则上下离脱，即便死矣。
葛根藤蔓延引，乃太阳经脉之药。本论云∶太阳病，项背强KT KT 无汗恶风，葛根汤主之。以明葛根治
太阳经脉之病，而非阳明之主药也。但色白味辛，可资阳明之燥。是从阳明而达太阳，与柴胡之从少阳而达
太阳者，其义一也。
石膏，色白，味辛，性寒，为阳明之主药。既为阳明主药，必确有阳明燥热之证，而元气不虚，可用；若元气
虚而燥热，必配人参，本论所以有人参白虎汤方。今人但知石膏清热泻火，遇伤寒大热之证，不审虚实阴
阳，每用石膏，用之而其病如故，复更用之。夫用之不效，与病便不相宜，粗工固执不解，明者视之，真堪堕
泪！余治伤寒，必审阴阳虚实，更必审似阴实阳、似阳实阴，确为阳明燥热之证，不涉太阳之热，不涉少阳之
火，里气不虚，始投石膏，配合成方，必一剂而奏功。此镇坠寒凝之药，不可屡用而常试者也。至儿科治痘，亦
用石膏，以为必先泻其火毒，方可顺序行浆。以此不经之见，横据胸中，无论痘之顺逆，至三五日间，必用石膏
以解毒。夫气血调和，其毒自解，石膏解毒，未之闻也。且痘原系先天火毒，必遇君火相火司天在泉之岁，其出
也广，是痘非火不出，非火不长，非火不浆，非火不合者也。夫痘毒之外，复有他火，可以暂用，而痘内之火，无
容泻也。其余杂证，或病阳明燥热，亦可用石膏以治，然非调和培养之药，不可不慎其用也。
医治伤寒发热，必用黄芩清热，谓小柴胡汤有黄芩也。夫既病伤寒，其身必热，而热有皮毛、肌腠、经脉
之不同，更有寒热相兼、假热真寒之各异。黄芩内空腐，外肌皮，空腐则内清肠胃之热，肌皮则外清肌表之热，
有彻内彻外之功。必审其内外皆热，原本壮实，胃气不虚，外不涉于毫毛，内不涉于经脉方用。若泛泛然举手
便用，其种祸不知几许矣！本论云∶仅与黄芩汤彻其热，腹中应冷，当不能食，戒之也。
黄芩之外，更有知母。知母肉白皮黄，皮上有毛，
气味苦寒，禀寒水之性，而兼秋金之气，犹水之知有母也，故名知母。土炎燥而皮毛热，可内资中土之燥，外
清皮毛之热。若以知母为补药，则非矣。
葳蕤，《本经》名女萎，女子娇柔之义也。一名玉竹，色白如玉，根节如竹也。一名青粘，苗叶青翠，根汁
稠粘也。凡此命名，皆取阴柔之义。后人妄称葳蕤有人参之功，不审阴阳寒热，用为补剂。若阴盛阳虚，宜
温补者，此药大忌。
麦冬，《本经》主治心腹结气，伤中伤饱，胃络脉绝。以麦冬横生土中，有十二余粒，其中则一心相贯∶能横
通胃络而补中，故治伤中；能横通胃络而散结，故治伤饱。后人用必去心，大非先圣格物穷理之意。妄谓连
心服之则心烦，盖即以连心麦冬煮水饮之，烦与不烦，可立辨矣。
泽泻，生于水中，其根如芋，能行水上滋。水气必上行而后下降，非专利小便之药也。今人不明经义，谓
目疾不可用，恐下泄其水则目枯，岂知泽泻正行水上滋之药也。《太阳篇》五苓散用泽泻，治消渴，小便不利。
以泽泻行水上滋，故治消渴、水气；上而始下，故利小便，犹木通之横通旁达，则小便自利。二者皆非下行
之药也。
参、术、苓、甘，加橘、半，为六君子汤。此健脾和胃，补泻兼行之方也。今人治大寒大虚证，既用参、
、术、姜、桂、附，而广皮、半夏，恋恋不舍，以六君子汤有橘、半故也。大抵临证施治，当就病用药，勿
执成方。广皮、半夏，乃辛散发汗之药，不可不知也。温补药中，有不宜归、芍者，以其润泄也。归、芍不宜，
而枣仁滋润亦不宜也。凡人抱病，阴不和阳，阳不和阴，自不能睡，如用枣仁，便即能睡，则天下无不睡之病
矣。经云∶人卧则血归于肝。身卧而血不归肝，则不能睡。又阴阳交会于坤土，太阴土虚，阴阳不归，则不能
睡。又阳明胃脉，其气下行，阳明气逆，上而不下，则不能睡。又厥阴主合，阳明亦主合，或阳明合而厥阴不
合，或厥阴合而阳明不合，或阳明、厥阴皆不能合，亦皆不能睡。当审其所以不睡之故而施治焉，庶其可尔！
八味丸，有熟地、桂、附，所以助三焦之火，益肾脏之水，乃阴阳兼补，水火并治者也。如阴虚而阳不虚，不
宜桂、附；若阳虚而阴不虚，便不宜熟地矣。今人遇阳虚之证，认为阴虚，大用熟地，奚可哉？
辛香下气，宽胸快膈，有沉香、丁香、木香、豆蔻、砂仁诸品，气味皆属辛香，而功用各有不同。沉香
从胸膈而下丹田，有下沉之义，故曰沉。丁香其性温热，助三焦之火以温胃土，丁者火也，故曰丁。木香，《本
经》名五香。五者，土也。采根阴干，一月方枯。人身经血，一月一周，肝木主之，故曰本。白豆蔻，宽胸药
也。肺居胸膈之上，肺气不布，则胸膈不通。豆蔻能达肺金之
气，肺属金，其色白，故曰白豆蔻。砂仁，原名缩砂 ，安胎药也，有归宿丹田，退藏于密之义。香附，乃莎
草根中之子，子结于根，亦有宿密之义，故亦主安胎，功用与缩砂略同。凡此辛香之药，臭味虽同，而功用稍
殊，当辨明而用，不可概投混施也。
天麻，苗如赤箭，故《本经》有赤箭之名。有风不动，无风独摇，故能制风。苗不可得，但有其根，是为
天麻。与蜀漆不可得，但有常山，一理也。天麻在土，形如大魁，似皇极之居中，周环十二子，如十二辰，
以辅皇极，味甘气平，主补中土，便从中土以通十二经。今人认为祛风之药，但品味甚优，误用亦无害也。
今人治疟，不用常山，以常山为截疟药，截之早，恐成臌胀。岂知常山乃治疟之要药，三阳轻浅之疟，不
必用也，若太阴脾土虚寒，而为脾寒之疟，及间二日发，而为三阴之疟，必须温补之剂，佐以常山，方能从阴
出阳，散寒止疟。又谓若服常山，终身不可食鸡。嗟嗟！此皆齐东野人之语，而明理之医，亦宗此说，良可嗤
矣！夫土虚脾败，天地不交，则成臌。疟既愈矣，何臌之有？
鹅、鸭、鳗、鳖，其性阴寒，病后宜忌。鸡性温平，补肝暖胃，疟后正可食也。终身必禁，是诚何说哉？
《本经》止有南星，并无胆星。南星色白味辛，禀金气而祛风豁痰，功同半夏。今人以牛胆制为瞻星，
味苦
性冷。中风痰涎上涌，多属三焦火虚，土崩水汛，斯时助正散邪，壮火祛寒，尤恐不济，而粗工昧昧，不审其
本，但治其末，服以苦冷之胆星，加以清凉之竹沥，必至生阳绝灭而死。
蒺藜，有刺蒺藜、白蒺藜二种。白蒺藜形如羊肾，微有腥气，乃从肾达肺之药。刺蒺藜色白有刺，秉坚金
攻伐之质，破积行瘀，乃大消大削之药。《诗》云∶墙有茨。即刺蒺藜也，后人误以白蒺藜为沙苑蒺藜，茨蒺藜
为白蒺藜。以攻伐之茨，认为健脾调补之药，岂不谬哉？
余每用银花，人多异之，谓非痈毒疮疡，用之何益？盖银花《别录》名忍冬藤。以银花之藤，至冬不凋，
乃宣通经脉之药也。又一本之中，花有黄、白，气甚芳香，故有金银花之名。金花走血，银花走气，又调和气血
之药也。通经脉而调气血，何病不宜？岂必痈毒而后用之哉！
药品种类繁多，不下千百种，其中日常常用的不过百十种。而在这一百十种药中，有真伪、好坏之分，使用也有适宜与不适宜之别，这些都应当明辨并详细了解。例如赤芍药、银柴胡、赤小豆、龙骨、巨胜子、半夏曲，都是伪药。《本草崇原》中已经辨析清楚，只是未曾刊印发行，这里暂且说明一下。
芍药花开有红色和白色两种，红花的是赤芍，白花的是白芍，总归是同一种植物，难道会有两样吗？如今儿科、外科多用赤芍，这是错误的。又有人把白芍当作酸敛的药物，哪里知道《神农本草经》记载其主治邪气腹痛，除血痹，破坚积，治寒热疝瘕，气味苦平。药性功效如此，难道是酸敛的吗？试着咀嚼芍药，哪里有酸味？这就可以纠正这种错误了。
柴胡有硬、软两种，硬的是大柴胡，软的是小柴胡。然而必须出自银州的才算上乘，所以有“银柴胡”这个名字。并不是在大小柴胡之外，另外还有一种叫银柴胡的药。
赤小豆属于谷物类，粗大的是赤豆，细小的是赤小豆。现在药店里有一种草籽，红黑相间，不能煮食，怎么能称为豆呢？
巨胜子就是胡麻。出自胡地大宛的为上品，所以有巨胜之名。刘晨、阮肇误入天台山，仙人用胡麻饭招待他们，指的就是巨胜子。现在药店里有一种有壳无仁的东西，其实是狗虱，用狗虱来冒充巨胜，妄立“壁虱胡麻”的名字。现在如果要用巨胜子，不如直接用大麻仁（大脂麻）算了。
龙骨，《神农本草经》列为上品药物，说是上天被贬谪的龙，在海滨深山间或许还有。现在的一种“龙骨”，其实是北方深山的石缝中的骨头，而不是上天降下的真龙之骨。龙是阳物，能兴云布雨，所以《伤寒论》中发汗的名方叫大青龙汤，利水的叫小青龙汤。现在想要止汗，反而用龙骨，这符合道理吗？《神农本草经》说它能止汗，是指用真龙的骨头研成细粉，扑洒全身，堵塞汗孔，这正是《伤寒论》中“以温粉扑之”的意思，并不是内服来止汗的意思。
考证《神农本草经》，只有半夏，并没有半夏曲。现在药店里用明矾水煮半夏，剩下的矾脚及半夏碎屑，大半混合麦曲，造成药饼，这就是半夏曲。时人喜欢新奇讨厌平常，方剂中经常使用，对病情有什么益处呢？除此之外，还有神曲，是用一百斤白面，加上青蒿、辣蓼、苍耳的自然汁，以及赤小豆、杏仁捣烂，拌面做成饼，发酵制成曲。儿科医生认为它是能治痰、止泻、消食的药物，常常使用，却不知道它的弊端。其他药物煮汁各有气味，如果使用神曲，那么药就像稠粥一样难喝，含有有形的面粉，大大损伤胃气。婴儿有病，必定忌讳面食，这种经过发酵的面饼，与酱有什么区别呢？况且里面有药汁和草汁，并不是健脾的物品，使用没有益处。
又有药物是伪品的，如桂枝、细辛、五味子、干姜等。张仲景的桂枝汤，使用的是去皮的桂枝，只取梢尖嫩枝，内外质地一致，气味辛香甜辣，桂枝皮内的木质部分就去除不用。这样的枝条，能多得吗？现在的人反而使用那种皮肉厚实的，也必须是辛香甜辣的，名叫川桂枝才行。现在药店里很难买到辛香甜辣的桂枝，即使有也是暂时性的，不久就没有。几十年中，我因为缺少好桂枝而不用它，不得已时用官桂代替。
北细辛，细得像头发一样，气味辛香冲鼻。如果细不如头发，辛香不冲鼻，那就是杜衡，使用它没有益处。
五味子，只有辽五味最好，颜色黑得像漆一样有光泽，味道像醋一样刺激牙齿，入口生津。其次是北五味，颜色红紫，微有光泽，味道也酸，微有香气。现在有一种黑色像李干兼带枯红色的，使用没有益处。
生姜是子姜，宣通胃气；干姜是母姜，温补脾阳。脾胃有母子之分，干姜、生姜也有母子之分。现在有金衢温台等地种植的姜，切片后坚实黄亮，才能入药，并不是本地生姜晒干伪充的，那种入口最辣，只能辛散表邪，温脾没有益处。
至于药物的适宜与不适宜，首先必须了解药性是否适宜，观察病人的病证，投药才合乎方义。现在世俗医生常用却不知是否适宜。这里略举十几钟药来说明。现在的医生发散解表，经常使用前胡，考证前胡，《名医别录》收录，陶宏景说：上古只有柴胡，而没有前胡的名字，后人开始使用。这说明宏景虽然收录了，但实际上是怀疑的。而且前胡降痰逐风，耗散正气，不如柴胡芳香，清热解表来得恰当。现在的人不研究药性，有病在太阳经，就过早使用柴胡，说有引邪入少阳的说法。其实柴胡又名地勋，苗叶非常芳香，从未见过邪气进入太阳经，它正是太阳经的主药。《伤寒论》说：如果没有太阳证……本论说：原本太阳病不解，转入少阳的，给予小柴胡汤。意思是病可以从少阳向外达于太阳，柴胡并不是少阳经的主药。它的药性是自下而上，从内而外，根气虚弱的人不可用，用了就像是拔苗助长，所以本论有“柴胡不中与之”的告诫。
至于升麻，也是拔根的药。现在的人遇到元气虚脱的证候，经常使用升麻，想要提升它使之上行。哪里知道升麻，《神农本草经》名为周麻，因为它具有升转周遍的功效，初起发散可以使用；如果是里虚气陷，应当补益元气，辅助它上升，不可以强行升提，强行升提会导致上下离脱，立刻就会死亡。
葛根藤蔓延引，是太阳经脉的药。本论说：太阳病，项背强几几无汗恶风，葛根汤主之。以此说明葛根治疗太阳经脉的病，而不是阳明经的主药。但是葛根色白味辛，可以资助阳明之燥。这是从阳明而达太阳，与柴胡从少阳而达太阳，道理是一样的。
石膏，色白，味辛，性寒，是阳明经的主药。既然是阳明主药，必须确有阳明燥热的证候，而且元气不虚，才可用；如果元气虚而有燥热，必须配伍人参，本论因此有人参白虎汤方。现在的人只知道石膏清热泻火，遇到伤寒大热的证候，不审虚实阴阳，经常使用石膏，用了之后病还是老样子，再继续使用。用药无效，说明与病情不相适宜，粗劣的医生固执不解，明智的人看了，真是让人流泪！我治疗伤寒，必定审察阴阳虚实，更必审察似阴实阳、似阳实阴的情况，确认为阳明燥热的证候，不涉及太阳的热，不涉及少阳的火，里气不虚，才开始投用石膏，配合成方，一定一剂见效。这是镇坠寒凝的药物，不可以屡次使用尝试。至于儿科治疗痘疹，也用石膏，认为必须先泻其火毒，才可以顺序行浆。凭着这种不经之见，横亘在心中，无论痘疹顺逆，到了三五天间，必定用石膏解毒。气血调和，毒自然解除，说石膏能解毒，我还没听说过。而且痘疹原本是先天火毒，必须遇到君火相火司天在泉的年份，出得广泛，痘非火不出，非火不长，非火不浆，非火不合。痘毒之外，如果有其他火邪，可以暂时使用石膏，但痘内部之火，不容许泻除。其余杂证，或者病属阳明燥热，也可以用石膏治疗，但它不是调和培养的药物，不可不慎重用。
医生治疗伤寒发热，必定用黄芩清热，说小柴胡汤里有黄芩。既然得了伤寒，身体必然发热，而热有皮毛、肌腠、经脉的不同，更有寒热相兼、假热真寒的差异。黄芩内空腐，外肌皮，空腐则内清肠胃之热，肌皮则外清肌表之热，有彻内彻外的功效。必须审察其内外皆热，原本壮实，胃气不虚，外不涉及毫毛，内不涉及经脉才使用。如果泛泛然举手就用，造成的祸患不知有多少！本论说：仅给予黄芩汤彻其热，腹中应冷，当不能食，这是告诫啊。
黄芩之外，还有知母。知母肉白皮黄，皮上有毛，气味苦寒，禀受寒水之性，而兼秋金之气，犹如水知道有母亲，所以名叫知母。土炎燥而皮毛热，可以内资中土之燥，外清皮毛之热。如果把知母当作补药，那就错了。
葳蕤，《神农本草经》名为女萎，取女子娇柔之意。一名玉竹，色白如玉，根节像竹子。一名青粘，苗叶青翠，根汁稠粘。凡此命名，都取阴柔之意。后人妄称葳蕤有人参的功效，不审阴阳寒热，用作补剂。如果阴盛阳虚，宜温补的，此药是大忌。
麦冬，《神农本草经》主治心腹结气，伤中伤饱，胃络脉绝。因为麦冬横生土中，有十二余粒，中间有一颗心贯穿：能横通胃络而补中，所以治伤中；能横通胃络而散结，所以治伤饱。后人使用时必定去心，大大违背了先圣格物穷理的本意。妄说连心服用会心烦，大概就是把连心的麦冬煮水喝，烦与不烦，可以立刻辨别。
泽泻，生长在水中，根像芋头，能行水上滋。水气必须上行然后下降，并不是专门利尿的药。现在的人不明白经义，说眼疾不可用，恐怕下泄水液导致眼睛干枯，哪里知道泽泻正是行水上滋的药。《太阳篇》五苓散用泽泻，治疗消渴，小便不利。因为泽泻行水上滋，所以治消渴、水气；上而始下，所以利小便，犹如木通横通旁达，小便自然通利。这两者都不是下行的药。
参、术、苓、甘，加上橘、半，组成六君子汤。这是健脾和胃，补泻兼行的方剂。现在的人治疗大寒大虚证，既用了参、术、姜、桂、附，又舍不得广皮、半夏，因为六君子汤里有橘、半的缘故。大抵临证施治，应当根据病情用药，不要拘执成方。广皮、半夏，是辛散发汗的药，不可不知道。温补药中，有不适宜当归、白芍的，因为它们润泄。归、芍不宜，枣仁滋润也不宜。凡是人生病，阴不和阳，阳不和阴，自然不能睡，如果用枣仁，就能睡觉，那天下就没有睡不着的病了啊。经书说：人卧则血归于肝。身体躺下而血不归肝，就不能睡。又阴阳交会于坤土，太阴土虚，阴阳不归，就不能睡。又阳明胃脉，其气下行，阳明气逆，上而不下，就不能睡。又厥阴主合，阳明亦主合，或者阳明合而厥阴不合，或厥阴合而阳明不合，或阳明、厥阴皆不能合，也都不能睡。应当审察其之所以不睡的原因而施治，这样才可以！
八味丸，有熟地、桂、附，所以助三焦之火，益肾脏之水，是阴阳兼补，水火并治的方子。如果阴虚而阳不虚，不适宜桂、附；如果阳虚而阴不虚，就不适宜熟地了。现在的人遇到阳虚的证候，认为是阴虚，大量使用熟地，怎么可以呢？
辛香下气，宽胸快膈，有沉香、丁香、木香、豆蔻、砂仁诸品，气味都属于辛香，而功用各有不同。沉香从胸膈而下丹田，有下沉的意义，所以叫沉。丁香其性温热，助三焦之火以温胃土，丁者火也，所以叫丁。木香，《神农本草经》名为五香。五者，土也。采根阴干，一个月才枯。人身经血，一月一周，肝木主之，所以叫本。白豆蔻，是宽胸药。肺居胸膈之上，肺气不布，则胸膈不通。豆蔻能达肺金之气，肺属金，其色白，所以叫白豆蔻。砂仁，原名缩砂仁，是安胎药，有归宿丹田，退藏于密的意义。香附，是莎草根中之子，子结于根，也有宿密的意义，所以也主安胎，功用与缩砂仁略同。凡此辛香的药，臭味虽同，而功用稍殊，应当辨明而用，不可以一概投混施。
天麻，苗像赤箭，所以《神农本草经》有赤箭之名。有风不动，无风独摇，所以能制风。苗得不到，只有根，这就是天麻。与蜀漆得不到，只有常山，是一个道理。天麻在土中，形状像大魁，似皇极居中，周围十二个子，像十二辰，以辅佐皇极，味甘气平，主补中土，便从中土以通十二经。现在的人认为是祛风的药，但品味甚优，误用也没有害处。
现在的人治疗疟疾，不用常山，因为常山是截疟药，截之早，恐怕形成臌胀。哪里知道常山是治疗疟疾的要药，三阳轻浅的疟疾，不必用，如果是太阴脾土虚寒，而为脾寒之疟，以及间二日发，而为三阴之疟，必须用温补的药剂，佐以常山，才能从阴出阳，散寒止疟。又说如果服用常山，终身不可吃鸡。唉！这都是齐东野人的话，而明理的医生也宗奉这种说法，实在可笑！土虚脾败，天地不交，才会形成臌胀。疟疾既然痊愈了，哪来的臌胀呢？
鹅、鸭、鳗、鳖，性质阴寒，病后应该禁忌。鸡性质温平，补肝暖胃，疟疾后正可以吃。终身必须禁止，这到底是什么说法呢？
《神农本草经》只有南星，并没有胆星。南星色白味辛，禀金气而祛风豁痰，功效同半夏。现在的人用牛胆制为胆星，味苦性冷。中风痰涎上涌，多属三焦火虚，土崩水汛，这时助正散邪，壮火祛寒，还怕不够，而粗劣的医生糊涂，不审察根本，只治末节，服用苦冷的胆星，加上清凉的竹沥，必定导致生阳绝灭而死。
蒺藜，有刺蒺藜、白蒺藜两种。白蒺藜形如羊肾，微有腥气，是从肾达肺的药。刺蒺藜色白有刺，秉坚金攻伐之质，破积行瘀，是大消大削的药。《诗经》说：墙有茨。就是刺蒺藜，后人误以为白蒺藜是沙苑蒺藜，茨蒺藜是白蒺藜。把攻伐的茨，认为是健脾调补的药，岂不荒谬？
我经常用银花，人们对此感到奇怪，说如果不是痈毒疮疡，用它有什么益处？盖因银花《名医别录》名为忍冬藤。因为银花的藤，到冬天不凋谢，是宣通经脉的药。又一本之中，花有黄、白两种，气味很芳香，所以有金银花之名。金花走血，银花走气，又是调和气血的药。通经脉而调气血，什么病不适合呢？难道一定要痈毒才用吗！
The variety of medicinal materials is vast, numbering no less than a thousand species. Among them, the commonly used daily items amount to only about one hundred. Within these one hundred species, there are distinctions between genuine and fake, good and bad, and their usage has appropriate and inappropriate applications; all of these must be clearly distinguished and thoroughly understood. For instance, Red Peony Root (Chishao), Silver Bupleurum (Yinchaihu), Red Adzuki Bean (Chixiaodou), Dragon Bone (Longgu), Giant Winning Seed (Jushengzi), and Pinellia Fermented Paste (Banxiaqu) are all fake medicines. *Bencao Chongyuan* has already clarified this, but it was not printed; here I shall briefly explain.
Peony flowers bloom in red and white varieties. The red-flowered ones are Red Peony Root (Chishao), and the white-flowered ones are White Peony Root (Baishao). They belong to the same plant; how could they be two different things? Nowadays, pediatric and surgical departments often use Red Peony Root (Chishao), which is erroneous. Furthermore, some regard White Peony Root (Baishao) as an astringent medicine. How can they know that *Shennong Bencao Jing* states its indications are for abdominal pain due to pathogenic factors, removing blood stasis, breaking firm accumulations, treating cold-heat hernias and masses, with a bitter and neutral flavor. Given such nature and function, how can it be astringent? Try chewing Peony Root; where is the sour taste? This can correct the error.
Bupleurum comes in hard and soft varieties. The hard one is Large Bupleurum (Da Chaihu), and the soft one is Small Bupleurum (Xiao Chaihu). However, those originating from Yinzhou are superior, hence the name "Silver Bupleurum" (Yinchaihu). It does not mean that besides Large and Small Bupleurum, there exists another herb called Silver Bupleurum.
Red Adzuki Bean belongs to the grain category. The coarse and large ones are Red Beans (Chidou), while the fine and small ones are Red Adzuki Beans (Chixiaodou). Currently, pharmacies sell a type of grass seed, mixed red and black, which cannot be cooked or eaten; how can it be called a bean?
Giant Winning Seed (Jushengzi) is Sesame (Huma). Those from Dayuan in Hu regions are superior, hence the name Giant Winning Seed. Liu Chen and Ruan Xi mistakenly entered Tiantai Mountain, where immortals fed them Huma Rice, which refers to Giant Winning Seed. Today, pharmacies sell a shell-without-kernel item, which is actually dog lice. Using dog lice to pass off as Giant Winning Seed and falsely naming it "Wall Louse Sesame" is absurd. If one wishes to use Giant Winning Seed today, it would be better to simply use Hemp Seed (Dazhima).
Dragon Bone (Longgu) is listed as a top-grade drug in *Shennong Bencao Jing*, described as the bone of a dragon banished by heaven, occasionally found near seashores or in deep mountains. The "Dragon Bone" sold now is actually stone-bone from cracks in deep northern mountains, not the true bone of a heavenly dragon. Dragons are Yang entities capable of raising clouds and bringing rain. Thus, in *Shanghan Lun*, the sweating formula is named Da Qinglong Tang (Major Azure Dragon Decoction), and the diuretic formula Xiao Qinglong Tang (Minor Azure Dragon Decoction). Now, if one wishes to stop sweating but uses Dragon Bone (Longgu), is this logical? When *Shennong Bencao Jing* mentions stopping sweat, it refers to grinding true dragon bone into fine powder and dusting it over the body to close sweat pores, consistent with the meaning of "dusting with warm powder" in *Shanghan Lun*. It does not refer to internal ingestion to stop sweating.
Examining *Shennong Bencao Jing*, there is only Ban Xia (Pinellia Rhizome), without Ban Xia Qu (Pinellia Fermented Paste). Pharmacies now boil Ban Xia in alum water; the remaining alum residue and Ban Xia fragments are mixed largely with wheat malt to form medicated cakes, known as Ban Xia Qu. People nowadays dislike the ordinary and seek novelty, frequently using it in prescriptions. What benefit does it bring to the illness? Besides this, there is Shen Qu (Medicated Leaven), made by mixing 100 jin of white flour with natural juices of Artemisia capillaris, Polygonum aviculare, Xanthium sibiricum, along with crushed Red Adzuki Beans and Apricot Kernels, formed into cakes and fermented. Pediatric doctors believe it treats phlegm, stops diarrhea, and aids digestion, often using it, unaware of its drawbacks. Other decoctions have distinct flavors; using Shen Qu makes the medicine resemble thick porridge. The solid flour content severely damages Stomach Qi. Infants with illness must avoid wheat products; this fermented cake is no different from sauce. Moreover, containing herbal juices, it is not a spleen-fortifying agent, offering no benefit.
Other fake drugs include Gui Zhi (Cinnamon Twig), Xi Xin (Asarum), Wu Wei Zi (Schisandra Berry), and Gan Jiang (Dried Ginger). Zhang Zhongjing's Guizhi Tang specifies using peeled Gui Zhi, taking only the tender tips of branches, uniform inside and out, with a pungent, sweet, and spicy aroma. The woody core inside the bark is removed and unused. Such branches are rare. Nowadays, people use the opposite, requiring a pungent, sweet, spicy flavor, labeled as Sichuan Cinnamon Twig (Chuanguizhi). In pharmacies, truly aromatic Gui Zhi is scarce; even if available, it fades quickly. For decades, I refrained from using it due to scarcity, substituting with Guan Gui (Official Cinnamon) when necessary.
Northern Xi Xin (Asarum) is hair-thin and pungently aromatic. If it is not hair-thin or lacks pungency, it is Ducheng (Duheng), which is useless.
Wu Wei Zi (Schisandra Berry): Liaoning Schisandra (Liao Wuwei) is best, black like lacquer with luster, sour like vinegar stimulating teeth, generating saliva upon entry. Northern Schisandra (Bei Wuwei) is second, reddish-purple with slight luster, sour with mild fragrance. A current variety resembling dried plums, black with withered red hues, is useless.
Fresh Ginger (Sheng Jiang) is young ginger, promoting Stomach Qi; Dried Ginger (Gan Jiang) is mature ginger, warming Spleen Yang. Just as Spleen and Stomach have mother-son relationships, so do Fresh and Dried Ginger. Ginger grown in Jin, Qu, Wen, Tai regions, sliced firm and bright yellow, is suitable for medicine. It is not locally sun-dried fresh ginger faked as such; the latter is extremely pungent, dispersing exterior pathogens but ineffective for warming the Spleen.
Regarding appropriateness, one must first understand drug properties and match them to the patient's condition. Modern physicians often use Qian Hu (Peucedani Radix) for releasing the exterior. *Bielu* records Qian Hu; Tao Hongjing noted that ancient times knew only Chai Hu (Bupleuri Radix), not Qian Hu, implying skepticism. Qian Hu descends phlegm and expels wind, depleting Qi, unlike Chai Hu which is aromatic, clears heat, and releases the exterior. Physicians ignorant of properties use Chai Hu early for Taiyang diseases, fearing drawing pathogens into Shaoyang. However, Chai Hu, also called Di Xun, has highly aromatic shoots and is indeed a Taiyang meridian herb. *Shanghan Lun* states: "If there are no Taiyang symptoms..." and "If original Taiyang disease unresolved turns to Shaoyang, give Xiao Chai Hu Tang." This implies reaching Taiyang from Shaoyang; Chai Hu is not primarily a Shaoyang herb. Its action is upward and outward; it should not be used in root Qi deficiency, akin to pulling seedlings to help them grow. Hence, the warning against using Chai Hu.
Sheng Ma (Cimicifugae Rhizoma) is also a rooting-pulling herb. Physicians often use it for collapsing Yuan Qi to lift it. However, *Bencao Jing* names it Zhou Ma, indicating its lifting and circulating function. It can be used for initial exterior release; for interior deficiency with sinking Qi, one should tonify Yuan Qi to assist ascent, not forcibly lift. Forcible lifting causes separation of upper and lower, leading to death.
Ge Gen (Puerariae Lobatae Radix) vines extensively and acts on the Taiyang meridian. *Shanghan Lun* states: "Taiyang disease, stiffness of neck and back, absence of sweat, aversion to wind, Ge Gen Tang governs." This clarifies Ge Gen treats Taiyang meridian pathology, not primarily Yangming. Its white color and pungent flavor can moisten Yangming dryness. It reaches Taiyang from Yangming, similar to how Chai Hu reaches Taiyang from Shaoyang.
Shi Gao (Gypsum Fibrosum) is white, pungent, and cold, the primary herb for Yangming. It requires confirmed Yangming dry-heat and sufficient Yuan Qi. If Yuan Qi is deficient with dry-heat, it must be combined with Ren Shen (Ginseng Radix et Rhizoma), as seen in Renshen Baihu Tang. Modern physicians know only Shi Gao clears heat and purges fire. Encountering severe heat in Shanghan, without assessing deficiency/excess or yin/yang, they repeatedly use Shi Gao. Ineffectiveness shows mismatch. Stubborn physicians fail to realize this; wise observers weep. I treat Shanghan by strictly assessing yin/yang and deficiency/excess, distinguishing false yin/true yang and vice versa. Only when confirming Yangming dry-heat, excluding Taiyang heat and Shaoyang fire, with solid interior Qi, do I use Shi Gao in formulas, expecting results in one dose. This heavy, cooling herb should not be tested repeatedly. Pediatricians use Shi Gao for smallpox to purge fire toxins before pustule formation. This unverified view persists regardless of prognosis, mandating Shi Gao on days 3-5. Harmonious Qi and Blood resolve toxins naturally; claiming Shi Gao resolves toxins is unheard of. Smallpox originates from congenital fire toxins, flourishing in years governed by Sovereign or Ministerial Fire. Poxes require fire to emerge, grow, form pus, and heal. External fire may warrant temporary Shi Gao, but internal pox fire must not be purged. For miscellaneous Yangming dry-heat cases, Shi Gao may be used, but it is not a harmonizing tonic; caution is required.
Physicians treating fever in Shanghan invariably use Huang Qin (Scutellariae Radix) for clearing heat, citing its presence in Xiao Chai Hu Tang. Since Shanghan causes fever, heat varies by location (skin, muscle, meridians) and nature (mixed cold-heat, false heat true cold). Huang Qin is hollow internally and fibrous externally; hollow parts clear intestinal/colonic heat, fibrous parts clear surface heat, acting throughout. It should only be used if both interior and exterior are hot, constitution strong, Stomach Qi robust, and no involvement of hairs/follicles or meridians. Indiscriminate use causes disaster. *Shanghan Lun* warns: "Only giving Huang Qin Tang to clear heat... abdomen should feel cold, inability to eat."
Besides Huang Qin, there is Zhi Mu (Anemarrhenae Rhizoma). Zhi Mu has white flesh and yellow hairy skin, bitter and cold flavor, embodying Cold Water nature and Autumn Metal qi, like water knowing its mother. It can moisten dry Earth from within and clear surface heat externally. Regarding it as a tonic is incorrect.
Wei Rui (Polygonati Odorati Rhizoma), named Nu Wei in *Bencao Jing*, means delicate maiden. Also called Yu Zhu (Jade Bamboo) for white jade-like color and bamboo-like nodes; Qing Nian for green leaves and sticky juice. All names imply yin delicacy. Later practitioners falsely attribute Ginseng-like effects to Wei Rui, using it as a tonic without assessing yin/yang or cold/heat. It is strictly contraindicated in excess yin and deficient yang requiring warming tonification.
Mai Dong (Ophiopogonis Radix) treats heart/stomach stagnation, middle injury, fullness, and severed stomach collaterals according to *Bencao Jing*. Mai Dong grows horizontally in soil with multiple tubers connected by a central heart. It horizontally connects stomach collaterals to tonify the middle (treating middle injury) and dissipate knots (treating fullness). Removing the heart contradicts ancient wisdom. The claim that consuming it with the heart causes irritability is baseless; testing it proves otherwise.
Ze Xie (Alismatis Rhizoma) grows in water, root like taro, capable of moving water upwards to nourish. Water Qi must ascend before descending; it is not merely a diuretic. Ignorant physicians forbid it for eye diseases, fearing fluid depletion causes dry eyes. Ze Xie actually promotes upward movement of water for nourishment. In Wuling San (*Taiyang Chapter*), Ze Xie treats thirst and difficult urination. By moving water up then down, it benefits urination, similar to Tong Cao (Tetrapanacis Medulla) spreading laterally. Neither is purely downward-draining.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Gan Cao (Licorice Radix et Rhizoma), plus Ju Pi (Citri Reticulatae Pericarpium) and Ban Xia (Pinelliae Rhizoma) form Liujunzi Tang (Six Gentlemen Decoction). This harmonizes Spleen and Stomach, combining tonification and draining. Modern physicians treating severe cold/deficiency use Ren Shen, Bai Zhu, Gan Jiang, Gui Zhi, Fu Zi, yet cling to Ju Pi and Ban Xia because they are in Liujunzi Tang. Treatment must follow the disease, not rigid formulas. Ju Pi and Ban Xia are pungent and dispersing; this must be known. In warming tonics, Dang Gui (Angelicae Sinensis Radix) and Bai Shao (Paeoniae Radix Alba) are unsuitable due to their moistening/draining nature. Suan Zao Ren (Ziziphi Spinosae Semen) is also unsuitable due to moisture. Illness disrupts Yin-Yang harmony, causing insomnia. Using Suan Zao Ren induces sleep, implying all insomnia could be cured thus. Classics state: "When sleeping, blood returns to the Liver." If lying down but blood doesn't return to Liver, insomnia occurs. Yin-Yang meet in Kun Earth; if Taiyin Earth is deficient, Yin-Yang don't merge, causing insomnia. Yangming Stomach Meridian Qi descends; if rebellious and ascending, insomnia occurs. Jueyin governs closing; Yangming also governs closing. Mismatch in closing mechanisms causes insomnia. One must diagnose the cause of insomnia to treat effectively.
Bawei Wan (Eight-Ingredient Pill) contains Shu Di Huang (Rehmanniae Radix Preparata), Gui Zhi, and Fu Zi to assist Sanjiao Fire and nourish Kidney Water, balancing Yin and Yang, Water and Fire. If Yin deficient but Yang not deficient, Gui Zhi and Fu Zi are unsuitable. If Yang deficient but Yin not deficient, Shu Di Huang is unsuitable. Modern physicians mistake Yang deficiency for Yin deficiency, heavily using Shu Di Huang, which is wrong.
Acrid-aromatic herbs descending Qi and opening the chest include Chen Xiang (Aquilariae Lignum Resinatum), Ding Xiang (Caryophylli Flos), Mu Xiang (Aucklandiae Radix), Dou Kou (Cardamomi Fructus), and Sha Ren (Amomi Fructus). Though acrid-aromatic, functions differ. Chen Xiang sinks from chest/diaphragm to Lower Dantian, hence "Sink". Ding Xiang is warm/hot, assisting Sanjiao Fire to warm Stomach Earth; "Ding" represents Fire, hence "Ding". Mu Xiang, named Wu Xiang (Five Fragrances) in *Bencao Jing*; Five corresponds to Earth. Roots dried in shade, wilting in a month. Human Qi/Blood circulates monthly, governed by Liver Wood, hence "Ben". Bai Dou Kou opens the chest; Lung resides above diaphragm. If Lung Qi fails to distribute, chest blocks. Dou Kou reaches Lung Metal Qi; Metal is white, hence "White Cardamom". Sha Ren, originally Suo Sha Ren, calms fetus, symbolizing returning to Dantian and hiding deeply. Xiang Fu (Cyperi Rhizoma) is the seed of Cyperus rotundus, attached to roots, also symbolizing deep hiding, thus calming fetus, similar to Suo Sha Ren. These acrid-aromatic herbs share scent but differ in function; distinguish carefully. Do not mix indiscriminately.
Tian Ma (Gastrodiae Rhizoma), shoot like Chi Jian (Ephedrae Herba), hence named Chi Jian in *Bencao Jing*. Still in wind, swaying alone without wind, thus controlling wind. Shoots unavailable, only roots used, hence Tian Ma. Similar to Shu Ki unavailable, only Chang Shan (Dichroae Radix) used. Tian Ma underground resembles a great chief, centered like Huang Ji, surrounded by twelve segments like twelve earthly branches, assisting the center. Sweet flavor, neutral qi, tonifies Central Earth, connecting Twelve Meridians. Moderns view it as wind-dispelling; though high quality, misuse is harmless.
Moderns treat malaria without Chang Shan, fearing early interception causes distension. Chang Shan is essential for malaria. Mild Yang-ming malaria needs not use it. For Taiyin Spleen-cold malaria or every-other-day Yin-malaria, warming tonics aided by Chang Shan draw pathogen from Yin to Yang, dispelling cold and stopping malaria. Claiming lifelong chicken prohibition after Chang Shan use is folk nonsense; rational physicians adopting this are laughable. Distension arises from Spleen failure and Heaven-Earth disconnect. If malaria cures, why distension?
Goose, duck, eel, turtle are yin-cold, contraindicated post-illness. Chicken is warm/neutral, tonifies Liver, warms Stomach, suitable post-malaria. Lifelong prohibition is illogical.
*Bencao Jing* lists Nan Xing (Arisaematis Rhizoma), not Dan Xing (Arisaematis Rhizoma Preparatum with Bovis Calculus). Nan Xing is white/pungent, embodies Metal Qi, dispels wind and resolves phlegm, similar to Ban Xia. Moderns process with Ox Gallbladder to make Dan Xing, bitter/cold. Stroke with phlegm surging often stems from Sanjiao Fire deficiency, Earth collapse, Water flooding. Here, supporting righteousness, expelling pathogens, strengthening Fire, dispelling Cold is urgent. Ignorant physicians, ignoring root, treating branch, prescribe bitter-cold Dan Xing and cool Bamboo Sap (Zhuli), leading to destruction of Life Fire and death.
Ji Li (Tribuli Fructus) has Ci Ji Li (Spiny Fruit) and Bai Ji Li (White Fruit). Bai Ji Li resembles sheep kidney, slightly fishy, moves from Kidney to Lung. Ci Ji Li is white/spiny, embodies Hard Metal attacking nature, breaks accumulations, moves blood stasis, a strong draining herb. *Shijing* says: "Wall has thistles," referring to Ci Ji Li. Later errors identified Bai Ji Li as Shayuan Ji Li, and Ci Ji Li as Bai Ji Li. Mistaking attacking Ci Ji Li for a spleen-tonifying herb is absurd.
I often use Yin Hua (Lonicerae Japonicae Flos); people question its use outside sores/carbuncles. *Bielu* names it Rendong Teng (Honeysuckle Stem). Its vine stays green in winter, promoting meridian circulation. One plant has yellow and white flowers, highly aromatic, hence Jinyinhua. Yellow flower enters Blood, White flower enters Qi; it harmonizes Qi and Blood. Promoting meridians and harmonizing Qi/Blood suits any disease. Must it be for sores only?